Individual provider Active NPI

Sudip Ringwala, D.O.

  • Allergy & Immunology Physician
  • Kenosha, WI
National Provider Identifier
1588956197
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
60091-21 Issued in WI
Practice address
4906 39TH Ave
Allergy and Asthma Clinic of Kenosha
Kenosha, WI 53144
Phone
(920) 203-5193
Fax
(920) 456-5590
NPI assigned
May 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X AS0799140035 NY
Allergy & Immunology Physician 207K00000X 60091-21 WI Primary

Addresses

Primary practice location

4906 39TH Ave
Allergy and Asthma Clinic of Kenosha
Kenosha, WI 53144

Mailing address

4906 39TH Ave
Kenosha, WI 53144-2108
Phone (920) 203-5193

Other identifiers 1

IdentifierTypeStateIssuer
1649202128MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813009593 WI Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 5597070037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4906 39TH Ave
Kenosha, WI 53144-2108
Phone (262) 657-9390

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
60091-21WIMDAllergy & Immunology Physician
AS0799140035NYMDInternal Medicine Physician

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAFIDD/Endpoint/FAFIDD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1305417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1588956197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 39TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531442108",
            "telephone_number": "920-203-5193",
            "fax_number": "262-657-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4906 39TH AVE",
            "address_2": "ALLERGY AND ASTHMA CLINIC OF KENOSHA",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53144",
            "telephone_number": "920-203-5193",
            "fax_number": "920-456-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINGWALA",
        "first_name": "SUDIP",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-15",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "AS0799140035",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "WI",
            "license": "60091-21",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649202128",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.